Possible EPI, Vet Waiting to Test due to Steroids?

Epi4Dogs Foundation Inc.’s mission is the advancement of science and education relating to EPI (Exocrine Pancreatic Insufficiency), yielding useful insights and positive outcomes in better managing EPI in dogs and cats. Our goals are to support and/or collaborate with veterinary EPI research and researchers, and to promote EPI awareness by educating the general public, pet owners, pet organizations, rescue and shelter organizations, veterinary schools and veterinarians.
Chance
Member
Posts: 193
Country: Canada
Pet name: Chance
My name: Andrea

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by Chance » 18 Apr 2023, 00:00

It's a terrible thing watching a dog waste away and nothing you do changes that! People judge. People can be cruel. Even vets that don't know you can be cruel.

I went through it with 2 dogs. One had Addison's disease. Weight melted off him very quickly. Extra food, it didn't matter. Of course Addison's was not the first thing tested for...everything, including exploratory surgery (which darn near killed him) came first. Finally they ram the ACTH stim test. Once that was treated, he gained weight quickly.

The other was EPI. Constantly being told he's just a dog with very high calorie needs. Routine blood work was done, which was always unremarkable. (Yellow Lab. Labs don't do underweight. It's not in their DNA. He was more than 20 lbs under in the end). He was started getting very weak, muscle was disappearing fast. He was pooping out pure food. (He's raw fed, so it was easy to see what meals were coming out when). Vet wasn't concerned. Just need to feed more. Finally I did my homework, and called the vet and said I want him tested for EPI. I was assured it was a waste of money. Just feed more. I insisted. He ran the test, but insisted he doesn't have EPI. A few days later he called and said "Chance has EPI. A very severe case of it"! It took a few weeks to get weight gain started, but after that he started gaining about 5 lbs a month!

Anyway, it sounds like your vets are much more on the ball. More willing to listen. It's frustrating and scary, but you'll get there!

You've already got great advice. But if EPI is suspected, it won't hurt to start giving enzymes now. Just need to fast before the test, and they won't interfere with the test. Especially if you are going to wait until the steroids are out of the system and do all testing at once.

Good luck! I hope you get the answer quickly and get to feeling better <3

User avatar
MamaOfGomo
Member
Posts: 22
Country: United States
State: Texas
Pet name: Kagome
My name: Cassidy

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by MamaOfGomo » 24 Apr 2023, 20:21

Update... bloodwork came back negative for EPI as most of everything looked normal, except she has low B12... The vet started talking about SIBO and getting a fecal done for that. My first instinct is... false negative?? Low B12 and possible SIBO sounds like EPI to me. I asked if I could put her on enzyme replacements anyways and obviously do B12 supplements and pre/probiotics and he gave me a greenlight. Any thoughts?
I'm Cassidy and I live in Austin, TX.

My pup is Kagome, a 9-year-old Pittie Mix who I foster failed in 2015.

She was tested for EPI on April 19th, 2023 and it came back negative for the usual markers.

She did however have low B12 and high Folate... so now we are chasing this trail... or tail?

More journey to come.

User avatar
MamaOfGomo
Member
Posts: 22
Country: United States
State: Texas
Pet name: Kagome
My name: Cassidy

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by MamaOfGomo » 24 Apr 2023, 20:33

Andrea,

I just saw your reply. Depsite a negative test, I'm going to get her the enzymes and try it out. We are testing for Cushings on May 3rd along with the fecal being sent to A&M for SIBO. I need to look into Addisons as well, as that is the next test if all else fails. Thank you for your input and suggestions <3
I'm Cassidy and I live in Austin, TX.

My pup is Kagome, a 9-year-old Pittie Mix who I foster failed in 2015.

She was tested for EPI on April 19th, 2023 and it came back negative for the usual markers.

She did however have low B12 and high Folate... so now we are chasing this trail... or tail?

More journey to come.

User avatar
Olesia711
Founder & Research Director
Posts: 3843
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by Olesia711 » 25 Apr 2023, 13:50

Hi Cassidy,

Glad that this is not EPI....at least you can scratch this off the list (for now) .... but sorry that you are still in limbo trying to figure out what in the world is going on.

Also, wanted to share with you, that there are many other health conditions that are not EPI that can have low B12 and SID at the same time. As a matter of fact.... just having SID alone depletes some of the inherent B12 stores.... so it is all kind of connected.

THere should not be a problem using the enzymes temporarily, especially if they do seem to help... but if possible do re-do the TLI test (in maybe 6 months) in the future if nothing else comes to light as the cause and if the same symptoms persist. What you do not want to do is give enzymes long term (like a year) with a non-EPI confirmed condition... as this too might eventually cause loose stools.

Please keep us posted on the next tests results!!
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

User avatar
MamaOfGomo
Member
Posts: 22
Country: United States
State: Texas
Pet name: Kagome
My name: Cassidy

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by MamaOfGomo » 25 Apr 2023, 19:59

Good to know about long term use of the enzymes! Do they mess with the TLI test if I happen to be giving them to her when we re-do the test? I'm really hoping we find answers with the two tests coming up. Fingers crossed.

I really appreciate your wealth of knowledge!
I'm Cassidy and I live in Austin, TX.

My pup is Kagome, a 9-year-old Pittie Mix who I foster failed in 2015.

She was tested for EPI on April 19th, 2023 and it came back negative for the usual markers.

She did however have low B12 and high Folate... so now we are chasing this trail... or tail?

More journey to come.

User avatar
Olesia711
Founder & Research Director
Posts: 3843
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by Olesia711 » 25 Apr 2023, 21:00

i too wish you luck with the next two tests... and as i said, please keep us posted!
To answer your question, no, giving enzymes DO NOT interfere with a TLI test... :)
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

User avatar
MamaOfGomo
Member
Posts: 22
Country: United States
State: Texas
Pet name: Kagome
My name: Cassidy

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by MamaOfGomo » 26 Apr 2023, 13:03

I just got the actual numbers from her test. After doing some reading it is common for dogs with SIBO to have low B12 and high folate due to the way bacteria interacts with these 2 things. I suppose that's why they want to do the fecal. Thoughts?


TLI Fasting
Interpretation: Result is within the reference interval.

Interval: 5.7-45.2 µg/L
Her Result: 26.3 µg/L

Pancreatic Lipase Immunoreactivity Fasting
Interpretation: Result within the reference interval. It is unlikely that this dog has clinically relevant pancreatitis. Investigate for other diseases that could cause the clinical signs observed.

Interval: ≤200 µg/L
Her Result: <30 µg/L

Cobalamin Fasting
Interpretation: Consistent with distal small intestinal disease, EPI or small intestinal bacterial overgrowth. Check canine TLI to rule out EPI. Consider oral or parenteral cobalamin
supplementation.

http://vetmed.tamu.edu/gilab/research/cobalamin-information

Interval: 251-908 ng/L
Her Result: <150 ng/L

Folate Fasting
Interpretation: May indicate small intestinal
dysbiosis, but can also be caused by recent folate supplementation. Consider performing a fecal dysbiosis index to further support that diagnosis.
Small intestinal dysbiosis often occurs secondary to chronic enteropathy or various other gastrointestinal disorders but can also be primary (idiopathic). Please see our website for discussion of treatment options.

http://vetmed.tamu.edu/gilab/research/folate-
information

Interval: 7.7-24.4 µg/L
Her result: 26.3 µg/L
I'm Cassidy and I live in Austin, TX.

My pup is Kagome, a 9-year-old Pittie Mix who I foster failed in 2015.

She was tested for EPI on April 19th, 2023 and it came back negative for the usual markers.

She did however have low B12 and high Folate... so now we are chasing this trail... or tail?

More journey to come.

User avatar
Olesia711
Founder & Research Director
Posts: 3843
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by Olesia711 » 26 Apr 2023, 13:59

Hi Cassidy,

Yeah, SID can happen with or without EPI... and SID can lower the B12 stores.
HOWEVER, yes, the folic acid/folate in B12 pills may increase the Folate score when tested.... BUT.... if the high folate score is attributed to an increase due to medication with folic acid/folate in it.... this would not also give a dog loose stools. If there are loose stools... then this is SID, not a false reading due to medication.

at this juncture:
she does not have EPI
she does have very low B12

and she does indeed appear to have dysbiosis, and their (TAMU) explanation is perfect :)
"Small intestinal dysbiosis often occurs secondary to chronic enteropathy or various other gastrointestinal disorders but can also be primary (idiopathic). Please see our website for discussion of treatment options."

And i agree with doing the dysbiosis test, cause at least you will know what (out of the 7 groups of bacteria) that you might be dealing with and then know what to give to fix things..... BUT.... before doing this... i would first wait to see if if the scheduled test says this is Cushings or Addisons...simply because if it is, then they will place her on the proper meds and this will clear up and you won't need to do a fecal test for dysbiosis.

HOWEVER... if, after testing, this is not Cushings or Addisons... then i would go ahead and have the dysbiosis test done to help you know how to treat her going forward.. at least with the dysbiosis.

Sometimes the even recommend a fecal transplant.... this is cheap and easy to do..... but only if needs to straighten out a bad case of dysbiosis that nothing else is helping.............

Lots to wrap your brain around.
Keep us posted, you are doing all the right things!!!
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

User avatar
MamaOfGomo
Member
Posts: 22
Country: United States
State: Texas
Pet name: Kagome
My name: Cassidy

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by MamaOfGomo » 03 May 2023, 12:06

Yes, lots to wrap the brain around!

I honestly feel disappointed by the negative EPI test. I was hoping for an answer and now it feels like 10 more doors have opened with only one closed. She was supposed to get her Cushings test done this morning, but my partner forgot about her appointment and fed her breakfast :cry: So, we are waiting on the vet to call us back and maybe get her in today for the dysbiosis test + she has new private part problems that also need to get addressed. So much going on... not enough brain power!

I'll continue putting our results and findings on here for anyone else who is going through a similar "is it this... or is it that?" situation.

Also, through all of this I did find a really great company (with decent prices!!) that I got Kagome probiotics and liver cleanse from last week. They have ALL kinds of supplements and probiotics, etc. I read that some of the best strains to use for a dog are soil based, since they are more resilient to the acids in the digestive system and also a strain called S. boulardii seems to have good results. This company happened to have a blend with all of this and more! Here are some links...

The probiotic I bought: https://fourleafrover.com/collections/products/products/protect

Their main website: https://fourleafrover.com

They ship in the US and Canada.

I also have her on a weight gain powder since the vet recommended a calorie supplement. I haven't gotten her weighed since shes been using it, so I cant say if it "works", but for anyone out there thats looking for a less processed weight gain option here is the link.

Weight gain powder: https://www.amazon.com/dp/B07LFG2BTF?psc=1&ref=ppx_yo2ov_dt_b_product_details

I'll post the next step of our journey when it happens! Thanks again for your support.
I'm Cassidy and I live in Austin, TX.

My pup is Kagome, a 9-year-old Pittie Mix who I foster failed in 2015.

She was tested for EPI on April 19th, 2023 and it came back negative for the usual markers.

She did however have low B12 and high Folate... so now we are chasing this trail... or tail?

More journey to come.

User avatar
Olesia711
Founder & Research Director
Posts: 3843
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by Olesia711 » 03 May 2023, 12:33

hi Cassidy,

I am a big proponent of using probiotics with S. boulardii . Just be careful with this product because of the bentonite clay... never give more than what is suggested. Otherwise it is a great product.... lots of really, REALLY good ingredients in it.

However, if/when you try it, say for a week and if you do not see any improvement, please let us know. I tried this product with my current non-EPI dog who had soft and then loose yellow-looking stools... cow pie pudding looking too sometimes... but he was tested, doesn't have EPI, nor Cushings, nor Addison's, tried hydrolyzed food, changed proteins tried 5 different probiotics, tried slippery elm, even tried Tylan for 3 days.... no improvement at all........ tested him multiple times and the ONLY thing was that his liver values were up...... but then i noticed that every time i gave brown rice his poos improved.... so i told my vet i wanted to try a high fiber food. ... just in case........... and OMG... instant improvement. which totally floored me, since i was so trained to see everything thru the eyes of a once EPI dog owner. BTW... his liver values have since gone back down to normal.

SOOOOOOOOO.... good product but watch the stools... take pictures.... and just saying.... don't lose heart.... i know it is frustrating.... and you want to make sure it is nothing serious... so do exactly what you are doing... checking for all the major things.... but it might be something very benign..... all you have to do is figure out what it is which is easily said but not so easy to do...................so..... keep posting when you can and we will help as best we can.
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

Post Reply

Who is online

Users browsing this forum: No registered users and 44 guests